| NPI | 1932121019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 6987) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: PA PT018214) |
| 225100000X Physical Therapist (Licence: WA PT 60237353) | |
| 225100000X Physical Therapist (Licence: OH PT013585) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2013-03-21 |