| NPI | 1649540741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 7532PT) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 114266) |
| Enumeration Date | 2012-01-05 |
| Last Update Date | 2012-01-05 |