| NPI | 1679035794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 3857) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1264511) |
| Enumeration Date | 2019-04-06 |
| Last Update Date | 2019-04-06 |