| NPI | 1114281995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: MT PTP-PT-LIC-13118) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 11959) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: CO PTL.0013292) | |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2024-04-30 |