| NPI | 1659596385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MT 519) |
| Additional Taxonomies | 172M00000X Mechanotherapist (Licence: MT 4096) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2013-04-15 |