| NPI | 1376671040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1163470) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX 1163470) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2020-08-27 |