| NPI | 1265917090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL..17507) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1310906) |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2021-08-24 |