| NPI | 1518376896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 15294-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1246068) |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2021-02-01 |