| NPI | 1821388661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1254370) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 11165) |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2021-07-29 |