| NPI | 1548754914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: MT PTP-PT-TMP-15011) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT 15076) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2019-07-05 |