| NPI | 1679022701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: SC PT8690) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT31810) |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2019-02-13 |