| NPI | 1790111581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 24755) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 28543) |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2013-12-11 |