| NPI | 1124552617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1058055) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX 1058055) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2022-12-07 |