| NPI | 1659615243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: HI PT4305) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 60046) |
| Enumeration Date | 2012-11-20 |
| Last Update Date | 2017-02-08 |