| NPI | 1639545841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1304627) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2021-01-22 |