| NPI | 1679645683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AK 2777) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT 492) |
| 363AM0700X Physician Assistant Medical (Licence: MT 298) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2014-06-10 |