| NPI | 1407946734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 9982) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA00991600) |
| 225100000X Physical Therapist (Licence: PA 019220) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2010-08-18 |