| NPI | 1023771896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1358784) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 09710R) |
| Enumeration Date | 2021-10-19 |
| Last Update Date | 2022-07-18 |