| NPI | 1457754285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P15043) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 25231) |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2015-01-13 |