| NPI | 1396393179 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P19261)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1321055)  | 
| Enumeration Date | 2019-08-26 | 
| Last Update Date | 2022-05-17 |