| NPI | 1720469745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TX 2126478) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 14-02663) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2021-07-08 |