| NPI | 1912475450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-33130) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: TX 1241017) |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2023-08-21 |