| NPI | 1811960610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0011106) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 2222) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2015-07-22 |