| NPI | 1578173597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: VT 040.0134158) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MD 28015) |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2023-01-16 |