| NPI | 1811439615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: WI 4290-24) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: WI 4290-24) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2022-01-10 |