| NPI | 1720420193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 10344) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: WI 12436-24) |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2015-04-27 |