| NPI | 1710942578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: DE J1-0001355) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: PA 04-475972) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2008-09-10 |