| NPI | 1063058758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NM PT5621) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 300951) |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2024-09-25 |