| NPI | 1629099601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 11356) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 22105) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2012-04-06 |