| NPI | 1710966833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 2684) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA QA0515100) |
| 225100000X Physical Therapist (Licence: CT 003918) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2012-06-18 |