| NPI | 1770765943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT020205) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 7871) |
| 225100000X Physical Therapist (Licence: CO PTL.0013409) | |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2018-09-13 |