| NPI | 1700123213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 8515083-2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 8515083-8016) |
| Enumeration Date | 2013-01-04 |
| Last Update Date | 2021-12-03 |