| NPI | 1376056325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1304269) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: TX 1242412) |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2023-04-21 |