| NPI | 1679134068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 11303675-2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P18853) |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2019-06-27 |