| NPI | 1760689459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT 4486) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 5454) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2013-02-20 |