| NPI | 1336796762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 10275) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: LA 10275) |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2023-12-28 |