| NPI | 1518027333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT00007331) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA PT4152) |
| 225100000X Physical Therapist (Licence: WI PT2502-024) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2007-07-08 |