| NPI | 1053788158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-30273) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 09119) |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2018-10-09 |