| NPI | 1568919785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT CP004612T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 22506) |
| Enumeration Date | 2016-09-06 |
| Last Update Date | 2022-12-11 |