| NPI | 1912544800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 28456) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: NV 3541) |
| Enumeration Date | 2019-12-10 |
| Last Update Date | 2022-02-24 |