| NPI | 1760267702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist Sports (Licence: UT 135256642401) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: UT 135256642401) |
| Enumeration Date | 2023-08-28 |
| Last Update Date | 2023-08-28 |