| NPI | 1952831075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P18896) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: LA 09566R) |
| 208100000X Physical Medicine & Rehabilitation (Licence: AL PTH8176) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: VA 2305210713) | |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2019-05-28 |