| NPI | 1750390217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 5031) |
| Additional Taxonomies | 2251G0304X Physical Therapist Geriatrics (Licence: AZ 5031) |
| 2251H1200X Physical Therapist Hand (Licence: AZ 5031) | |
| 2251X0800X Physical Therapist Orthopedic (Licence: AZ 5031) | |
| 2251P0200X Physical Therapist Pediatrics (Licence: AZ 5031) | |
| 2251S0007X Physical Therapist Sports (Licence: AZ 5031) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2007-10-23 |