| NPI | 1104356617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1224188) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: TX 1224188) |
| Enumeration Date | 2017-06-16 |
| Last Update Date | 2018-03-17 |