| NPI | 1053499509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 8607) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT019096) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2021-08-04 |