| NPI | 1316394943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: NE 3567) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SD 1906) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2020-07-01 |