| NPI | 1982080487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 12833) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2015028023) |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2022-07-21 |