| NPI | 1033607916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 12313) |
| Additional Taxonomies | 2251G0304X Physical Therapist Geriatrics (Licence: AZ 12313) |
| 2251N0400X Physical Therapist Neurology (Licence: AZ 12313) | |
| 2251S0007X Physical Therapist Sports (Licence: AZ 12313) | |
| 2251X0800X Physical Therapist Orthopedic (Licence: AZ 12313) | |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2018-04-26 |