| NPI | 1790782043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT 2035) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 01101) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2010-05-12 |