| NPI | 1780930362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1217998) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: TX 1217998) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: TX 1217998) | |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2019-05-01 |