| NPI | 1750806717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P17136) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1292341) |
| Enumeration Date | 2017-08-10 |
| Last Update Date | 2018-05-30 |