| 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 |