| NPI | 1043752959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT015022) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1283546) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2021-01-26 |