| NPI | 1497451132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2021042629) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT-32944) |
| Enumeration Date | 2023-02-03 |
| Last Update Date | 2026-03-22 |