| NPI | 1073096061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 31207) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 22965) |
| Enumeration Date | 2018-09-14 |
| Last Update Date | 2020-09-15 |