| NPI | 1861476871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 11724) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 011702) |
| 2251S0007X Physical Therapist, Sports (Licence: CO 8904) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: CO 8904) | |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2007-07-08 |