| NPI | 1427682780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-31364) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1328556) |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2020-10-16 |