| NPI | 1710057641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 10778) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2007-07-08 |