| NPI | 1356823561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1306729) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OK 4931) |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2020-08-11 |