| NPI | 1699768317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 1199) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 1024) |
| Enumeration Date | 2005-08-28 |
| Last Update Date | 2007-07-08 |