| NPI | 1467702019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 11037) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: WI 11037-24) |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2014-06-11 |