| NPI | 1588874135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: AL PTH4155) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL PTH4155) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2015-06-04 |