| NPI | 1235684820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 12513PT) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT025358) |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2020-11-19 |