| NPI | 1104867985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OK 5613) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1144913) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2022-08-16 |