| NPI | 1518496413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305214316) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OK 5302) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: VA 2305214316) | |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2021-06-11 |