| NPI | 1659719805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NM 4316) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 8602588-2401) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2020-07-02 |