| NPI | 1578820205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2015039231) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AK 2413) |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2017-03-27 |