| NPI | 1811570856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1344293) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 045358) |
| Enumeration Date | 2021-04-28 |
| Last Update Date | 2022-11-15 |