| NPI | 1588694756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 326091-2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 02149) |
| 225100000X Physical Therapist (Licence: IL 070-006197) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2007-07-08 |