| NPI | 1962551267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT2244) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 06545R) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2007-07-09 |