| NPI | 1417401902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2016033670) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1261996) |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2016-09-16 |