| NPI | 1255812657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH9044) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305212581) |
| 225100000X Physical Therapist (Licence: TX 1313482) | |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2020-01-22 |