| NPI | 1790470474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-32956) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0017446) |
| Enumeration Date | 2023-04-07 |
| Last Update Date | 2023-06-28 |