| NPI | 1912673898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-31898) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: AZ LPT-31898) |
| Enumeration Date | 2021-08-19 |
| Last Update Date | 2022-01-06 |