| NPI | 1982602645 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 12518) | 
| Additional Taxonomies | 2251H1200X Physical Therapist, Hand (Licence: CT 004444) | 
| 2251H1200X Physical Therapist, Hand (Licence: VA 2305208812) | |
| Enumeration Date | 2005-07-07 | 
| Last Update Date | 2021-01-29 |