| NPI | 1376778621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX 1209750) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT24667) |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2011-11-07 |