| NPI | 1639827462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT40454) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 14130) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: TN 14130) | |
| Enumeration Date | 2022-03-10 |
| Last Update Date | 2023-08-24 |