| NPI | 1619113123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AK 2108) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: AK 2108) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: AZ 8225) | |
| Enumeration Date | 2009-01-05 |
| Last Update Date | 2017-06-12 |