| NPI | 1790938900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 30547) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 17548) |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2019-10-03 |