| NPI | 1891822532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WI 10066) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 19481) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2012-02-27 |