| NPI | 1356638324 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 7090) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT021365) | 
| Enumeration Date | 2011-06-29 | 
| Last Update Date | 2013-09-27 |