| 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 |