| NPI | 1124556402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1329155) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P17163) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2020-06-12 |