| NPI | 1407062813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT022882) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1238770) |
| 225100000X Physical Therapist (Licence: VA 2305208377) | |
| 225100000X Physical Therapist (Licence: OR 60530) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2014-10-04 |