| NPI | 1043323520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 6727) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 6727) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2019-06-04 |