| NPI | 1235296112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2002023324) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: MO 39669) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: MO 22067) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2024-07-03 |