| NPI | 1821110651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 8317) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: GA 002190) |
| 225100000X Physical Therapist (Licence: GA PT012335) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2017-01-20 |