| NPI | 1396139689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305209179) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1200163) |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2019-02-13 |