| NPI | 1972506905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 004194) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 6793) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2019-02-19 |