| NPI | 1497308050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 64584) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT-30887) |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2023-01-25 |