| NPI | 1154676195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1313569) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 035082) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2020-01-06 |