| NPI | 1164034112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 014130) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: AZ 014130) |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2020-08-20 |