| NPI | 1508240474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 61157) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1260143) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2019-12-23 |