| NPI | 1780013490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 3148) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 9854) |
| Enumeration Date | 2013-11-03 |
| Last Update Date | 2014-01-06 |