| NPI | 1700068541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 5336) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA AH19352) |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2019-03-11 |