| NPI | 1881109601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-31260) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P17574) |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2025-09-16 |