| NPI | 1629394655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 12209) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 8411) |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2020-10-12 |