| NPI | 1003275561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1297769) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12880) |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2023-12-11 |