| NPI | 1740669878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 116521) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 072.0107619) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2015-05-21 |