| NPI | 1013537026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 1323034) |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2021-09-14 |