| NPI | 1659121192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-012930) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501303066) |
| Enumeration Date | 2024-03-26 |
| Last Update Date | 2024-03-26 |