| NPI | 1972153419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: VA 2305213131) |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2019-09-24 |