| NPI | 1700402450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-31224) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 64095) |
| 225100000X Physical Therapist (Licence: VA CP008308T) | |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2021-11-22 |