| NPI | 1558856005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0017629) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT-30116) |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2021-05-25 |