NPI | 1124558416 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: NC P17165) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P17165) |
2251X0800X Physical Therapist, Orthopedic (Licence: SC 9494) | |
Enumeration Date | 2017-06-19 |
Last Update Date | 2022-01-02 |