| NPI | 1639739576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 034059) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: AZ 12419A) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2025-02-11 |