| NPI | 1851864151 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1313236) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 60575398) | 
| Enumeration Date | 2019-01-09 | 
| Last Update Date | 2019-01-09 |