NPI | 1316432610 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: IA 096133) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2018020774) |
Enumeration Date | 2018-06-28 |
Last Update Date | 2019-07-02 |