| NPI | 1780082495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 12746-24) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: WI 1274624) |
| Enumeration Date | 2014-12-11 |
| Last Update Date | 2017-04-27 |