| NPI | 1124495981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: TX 1277363) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT024639) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: PA PT024639) | |
| Enumeration Date | 2015-08-27 |
| Last Update Date | 2024-07-22 |