| NPI | 1962417311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-2198) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 7959) |
| 225100000X Physical Therapist (Licence: ID PT-2009) | |
| 225100000X Physical Therapist (Licence: UT 329940-2401) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2016-08-17 |