| NPI | 1356916530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: TX 1350086) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1350086) |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2022-08-25 |