| NPI | 1306258181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 11618) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12717) |
| 2251S0007X Physical Therapist, Sports (Licence: AZ 11618) | |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2023-09-06 |