| NPI | 1194123174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-31124) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05011176A) |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2020-08-03 |