| NPI | 1558697995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: LA 08268R) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS PT4621) |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2014-07-08 |