| NPI | 1629478649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1235690) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: MN 9450) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2018-10-31 |