| NPI | 1861823809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: VA 2305212762) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: FL 28405) |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2019-09-05 |