| NPI | 1265850119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS 6279) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1237480) |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2021-09-28 |