| NPI | 1619571445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ CP015862T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 15300-24) |
| Enumeration Date | 2020-11-23 |
| Last Update Date | 2022-12-23 |