| NPI | 1083797120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: TX 1399959) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT33197) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2024-10-14 |