| NPI | 1689271611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1331285) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ND 2275) |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2020-10-02 |