| NPI | 1932450764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 13339) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 27778) |
| 225100000X Physical Therapist (Licence: SC 6803) | |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2016-08-03 |