| NPI | 1104598432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 12324270-2401) |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2024-11-01 |