| NPI | 1518937036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 6735) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2010-06-10 |