| NPI | 1104018449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: OR 60083) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 6552061-2401) |
| 225100000X Physical Therapist (Licence: AK 2364) | |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2020-04-09 |