| NPI | 1629048657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT000362E) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA DA PT000713) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2007-07-08 |