| NPI | 1093203879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 12139998-2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AK 130546) |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2021-03-26 |