| NPI | 1174175400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AK 189941) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1279251) |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2025-07-02 |