| NPI | 1023595253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 4054) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT-30131) |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2020-09-03 |