| NPI | 1982681862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 3597-024) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 225100000X) |
| 2251H1200X Physical Therapist, Hand (Licence: WI 3597024) | |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2012-10-31 |