| NPI | 1326560285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: VT 040.0131361) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VT 040.0131361) |
| 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: VT 131361) | |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2020-01-23 |