| NPI | 1336861400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-32649) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 16050) |
| Enumeration Date | 2022-09-15 |
| Last Update Date | 2024-04-26 |