| NPI | 1972101087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225800000X Recreation Therapist (Licence: AZ LPT-31243) |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2024-09-03 |