| NPI | 1811551591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 10943330-2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2018040833) |
| 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-13205) | |
| Enumeration Date | 2019-04-27 |
| Last Update Date | 2019-05-16 |