| NPI | 1376947705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO ptl.0011837) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: HI pt-3860) |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2014-10-14 |