| NPI | 1629521406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 11701046-2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 295767) |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2020-10-23 |