| NPI | 1003266537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: FL 31525) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 31525) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: FL 31525) | |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2019-06-11 |