| NPI | 1629461462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1242643) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: HI PT-4672) |
| 225100000X Physical Therapist (Licence: CO PTL.0013586) | |
| Enumeration Date | 2015-03-17 |
| Last Update Date | 2018-12-06 |