| NPI | 1366602633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL 005717) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT5717) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2008-10-01 |