| NPI | 1205113586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1289376) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AR PT 2555) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2022-07-21 |