| NPI | 1316197650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 21039) |
| Additional Taxonomies | 2251S0007X Physical Therapist Sports |
| 2251G0304X Physical Therapist Geriatrics | |
| 2251X0800X Physical Therapist Orthopedic (Licence: MD 21039) | |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2020-10-30 |