| NPI | 1235794686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-30586) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 24173) |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2020-12-10 |