| NPI | 1619252731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1230867) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2002007673) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2021-09-13 |