| NPI | 1780152272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1359208) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-07109) |
| 225100000X Physical Therapist (Licence: GA PT013764) | |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2022-08-15 |