| NPI | 1619450038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1315933) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2102470) |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2019-03-17 |