| NPI | 1760883391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1246266) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-05520) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2016-11-16 |