| NPI | 1265820708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 21492) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1186269) |
| Enumeration Date | 2015-01-07 |
| Last Update Date | 2015-01-07 |