| NPI | 1508233479 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 12831)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM 4667)  | 
| Enumeration Date | 2015-08-27 | 
| Last Update Date | 2018-03-23 |