| NPI | 1629484217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 61167) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1244700) |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2016-07-21 |