| NPI | 1053824615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 09833) |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: LA 09833) |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2023-03-23 |