| NPI | 1588612535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS 4478) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TN 6889) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2011-01-12 |