| NPI | 1962611046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 6722) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AK 1563) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2012-04-09 |