| NPI | 1780458679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 033435) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 41040) |
| Enumeration Date | 2023-11-10 |
| Last Update Date | 2024-07-15 |