| NPI | 1972742831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 11169) |
| Additional Taxonomies | 174400000X Specialist (Licence: WI 11169-024) |
| Enumeration Date | 2009-02-16 |
| Last Update Date | 2016-06-29 |