| NPI | 1750646170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0012457) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 3090) |
| 225100000X Physical Therapist (Licence: IA 005273) | |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2015-09-24 |