| NPI | 1619598786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: WI 1475724) |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2023-05-12 |