| NPI | 1851058622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1386171) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 25888) |
| Enumeration Date | 2021-11-29 |
| Last Update Date | 2024-11-25 |