| NPI | 1659307031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 072167) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: MO PT110022) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2014-06-18 |