| NPI | 1861702870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 24846) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT25870) |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2019-04-24 |