| NPI | 1750093431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 104080562401) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2022-12-14 |
| Last Update Date | 2022-12-14 |