| NPI | 1669138517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
| Additional Taxonomies | 225100000X Physical Therapist |
| 2251S0007X Physical Therapist, Sports | |
| Enumeration Date | 2021-11-15 |
| Last Update Date | 2021-11-15 |