| NPI | 1407153166 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 2950)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 004717)  | 
| Enumeration Date | 2011-02-16 | 
| Last Update Date | 2011-02-16 |