| NPI | 1972769628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: SC 9374) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT019384) |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2020-07-27 |