| NPI | 1770936239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: VA 2305213420) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: HI PT-4211) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2022-04-07 |