NPI | 1104416452 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: MD 28354) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
2251S0007X Physical Therapist, Sports | |
Enumeration Date | 2021-01-21 |
Last Update Date | 2022-01-10 |