| NPI | 1164071023 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 30836) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 10459) | 
| Enumeration Date | 2019-09-04 | 
| Last Update Date | 2023-03-02 |