| NPI | 1740728773 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ CP043593T)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC p16904)  | 
| Enumeration Date | 2017-02-10 | 
| Last Update Date | 2025-05-14 |