| NPI | 1164093274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1345804) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0017736) |
| Enumeration Date | 2021-07-08 |
| Last Update Date | 2021-07-08 |