| NPI | 1366086407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 21022) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MA 21022) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MA 21022) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MA 21022) | |
| 208VP0000X (Licence: MA 21022) | |
| Enumeration Date | 2019-11-01 |
| Last Update Date | 2019-11-01 |