| NPI | 1932756939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SD 2200) |
| Additional Taxonomies | 2083S0010X Preventive Medicine, Sports Medicine (Licence: IA 083635) |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2020-03-26 |