| NPI | 1619273380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14102) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-018273) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: NC P16218) | |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2021-01-08 |