| NPI | 1609460500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NM PT22063) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT-010568) |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2023-02-22 |