| NPI | 1821624479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 9626) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: SC 9626) |
| Enumeration Date | 2020-03-16 |
| Last Update Date | 2021-07-22 |