| NPI | 1992755185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 10267-024) |
| Additional Taxonomies | 2251S0007X Physical Therapist Sports (Licence: CO 8763) |
| 2251X0800X Physical Therapist Orthopedic (Licence: CO 8763) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2020-09-15 |