| NPI | 1780109454 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-32535)  | 
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NM 5081)  | 
| Enumeration Date | 2017-08-03 | 
| Last Update Date | 2023-08-15 |