| NPI | 1750413688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 10978-024) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2006017287) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2016-10-05 |