| NPI | 1407856644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1146477) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 06562r) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2020-11-09 |