| NPI | 1376638379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 00914R) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT22753) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-09-15 |