| NPI | 1114447653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 13104) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-7712) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2021-12-03 |