| NPI | 1083278345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2018029941) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1304742) |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2019-04-23 |