| NPI | 1972642866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 05762) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 17450) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2012-11-02 |