| NPI | 1962688150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 8032) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 4603-024) |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2017-01-13 |