| NPI | 1720747579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 09527R) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1282375) |
| Enumeration Date | 2021-12-09 |
| Last Update Date | 2021-12-09 |