| NPI | 1245767326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 13739) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2017003428) |
| Enumeration Date | 2017-05-19 |
| Last Update Date | 2020-05-04 |