| NPI | 1093248098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1268123) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: TN 11150) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2018-04-10 |