| NPI | 1962629568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 17554) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT016300) |
| 225100000X Physical Therapist (Licence: WA PT60433156) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2016-02-17 |