| NPI | 1164923819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P17703) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: NC 17703) |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2020-02-24 |