| NPI | 1578658324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 5275) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT25401) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2015-10-07 |