| NPI | 1972508380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: LA 02679) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 02679) |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2018-06-15 |