| NPI | 1205953056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 8390) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 17158) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2021-06-21 |