| NPI | 1740250281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 02905) |
| Additional Taxonomies | 2251S0007X Physical Therapist Sports (Licence: IA 02905) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2020-09-16 |