| NPI | 1962699579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT6646) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 070-1883) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2015-05-20 |