| NPI | 1922087386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC PT5802) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: CA PT 18206) |
| 2251S0007X Physical Therapist, Sports (Licence: VA 2305206054) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: MA 3860) | |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2023-05-02 |