| NPI | 1629203880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1188926) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2019-10-17 |