| NPI | 1205347275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT30960) |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2026-04-14 |