| NPI | 1255617049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AZ 9251) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT-009251) |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2025-03-24 |