| NPI | 1174931919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AR PT4329) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: AR 3855) |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2023-08-14 |