| NPI | 1770711426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 28140) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 008570) |
| 225100000X Physical Therapist (Licence: VA 2305207540) | |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2013-05-22 |