| NPI | 1720058530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 4769) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 40QA00746800) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2009-05-15 |