| NPI | 1962201053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0020458) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT-033523) |
| Enumeration Date | 2025-03-11 |
| Last Update Date | 2025-03-11 |