| NPI | 1952665721 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: AZ 9819) | 
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: AZ 9819) | 
| Enumeration Date | 2012-06-27 | 
| Last Update Date | 2012-06-27 |