| NPI | 1124685383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX PT1306889) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT33953) |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2019-05-23 |