| NPI | 1073858957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: AZ 10065) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 10065) |
| 2251S0007X Physical Therapist, Sports (Licence: AZ 10065) | |
| Enumeration Date | 2012-12-04 |
| Last Update Date | 2018-03-17 |