| NPI | 1700174257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH6569) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 26479) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2012-11-30 |