| NPI | 1720130347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: 10640PT) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: AZ 290846347) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2015-10-29 |