| NPI | 1700217924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 10413) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 10413) |
| Enumeration Date | 2013-12-13 |
| Last Update Date | 2017-03-28 |