| NPI | 1922474741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 10154) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0012960) |
| 225100000X Physical Therapist (Licence: MS PT 5002) | |
| Enumeration Date | 2015-08-16 |
| Last Update Date | 2015-08-17 |