| NPI | 1023124062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: VA 2305206836) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: MA 16789) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2017-05-26 |