| NPI | 1629054804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1123057) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM 2986) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2018-12-04 |