| NPI | 1740807940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OK 5619) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: OK 5619) |
| Enumeration Date | 2020-07-03 |
| Last Update Date | 2020-07-08 |