| NPI | 1063066934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 31874) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2019027824) |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2021-07-19 |