| NPI | 1811300809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2016037916) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT011368) |
| 225100000X Physical Therapist (Licence: AZ PT9406) | |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2017-03-02 |