| NPI | 1912065533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 005025) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 16671) |
| 225100000X Physical Therapist (Licence: NY 025377-1) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2007-07-08 |