| NPI | 1578546271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: MT 812) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT 812) |
| 2251S0007X Physical Therapist Sports (Licence: MT 812) | |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2023-05-24 |