| NPI | 1568670644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251S0007X Physical Therapist Sports (Licence: FL PTFL4075) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: FL PTFL4075) |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2007-07-08 |