| NPI | 1952140097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA CP030773T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT-31833) |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2024-05-20 |