| NPI | 1073891032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1265672) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2011021959) |
| 225100000X Physical Therapist (Licence: KS 11-04321) | |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2017-02-06 |