| NPI | 1619359791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2015021002) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1259322) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2019-09-10 |