| NPI | 1740762186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1062198) |
| Additional Taxonomies | 247200000X (Licence: TX 88979) |
| Enumeration Date | 2018-09-01 |
| Last Update Date | 2019-06-16 |