| NPI | 1568735256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14140) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 10402) |
| Enumeration Date | 2012-02-12 |
| Last Update Date | 2018-09-28 |