| NPI | 1972704831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD PT22274) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL8903) |
| 225100000X Physical Therapist (Licence: PA PT017694) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2019-02-19 |