| NPI | 1467863720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 009951) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 24659) |
| 225100000X Physical Therapist (Licence: NC P14558) | |
| 225100000X Physical Therapist (Licence: VA 2305208376) | |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2014-05-09 |