| NPI | 1053807321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1339341) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305212091) |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2021-03-12 |