| NPI | 1790158665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: NC P16389) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: MD 25694) |
| Enumeration Date | 2015-11-02 |
| Last Update Date | 2021-05-06 |