| NPI | 1912561499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 29426) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: DC 872576) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2024-03-04 |