| NPI | 1568913259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 16331) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 12358) |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2020-12-11 |