| NPI | 1679761712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 06999) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 18063) |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2014-05-28 |