| NPI | 1104028372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-013368) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 22238) |
| 208100000X Physical Medicine & Rehabilitation (Licence: AZ LPT-013368) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2024-02-07 |