| NPI | 1104174770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 14192) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: VA 2305207592) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: TN 14192) | |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2025-07-11 |