| NPI | 1316211618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1267547) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2011031112) |
| Enumeration Date | 2012-03-04 |
| Last Update Date | 2021-03-09 |