NPI | 1417575291 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305213562) |
Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: FL 38102) |
Enumeration Date | 2020-07-08 |
Last Update Date | 2025-08-18 |