| NPI | 1356967558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 1328824) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1251920) |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2021-01-03 |