| NPI | 1801345459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 3129689) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2123461) |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2024-05-24 |