| NPI | 1386202455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1353700) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 14962) |
| 225100000X Physical Therapist (Licence: MN 11467) | |
| 225100000X Physical Therapist (Licence: ND 2298) | |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2022-01-19 |