| NPI | 1710031745 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NH 2601) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 7031) | 
| Enumeration Date | 2007-01-23 | 
| Last Update Date | 2007-07-08 |