| NPI | 1265885933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 12332PT) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AK PHYP2636) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2019-09-20 |