| NPI | 1760961841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2018042914) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT-30193) |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2022-01-23 |