| NPI | 1558842310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-31032) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 11925) |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2022-08-01 |