| NPI | 1790080513 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH10871) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AR 2965) | 
| Enumeration Date | 2011-01-26 | 
| Last Update Date | 2022-09-15 |