| NPI | 1568577203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 28021) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: AK PHYP1560) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2020-09-11 |