| NPI | 1225485519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1355284) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2120253) |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2022-01-04 |