| NPI | 1639429772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1169387) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: TX 1169387) |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2019-01-22 |