| NPI | 1720469943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P15596) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: NC P15596) |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2020-10-26 |