| NPI | 1346677739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 7228) |
| 225100000X Physical Therapist (Licence: LA 09606R) | |
| 225100000X Physical Therapist (Licence: TX 1259760) | |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2018-07-30 |