| NPI | 1679190391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0017013) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT-31345) |
| Enumeration Date | 2020-06-29 |
| Last Update Date | 2024-07-03 |