| NPI | 1023312402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-009195) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 9195) |
| Enumeration Date | 2010-12-29 |
| Last Update Date | 2024-10-22 |