| NPI | 1942367891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist Sports (Licence: AZ 5418) |
| Additional Taxonomies | 2251S0007X Physical Therapist Sports (Licence: CA 29327) |
| 2251S0007X Physical Therapist Sports (Licence: FL 23383) | |
| 2251S0007X Physical Therapist Sports (Licence: NV 2144) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2007-09-15 |