| NPI | 1861050551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1347217) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 296504) |
| 2251S0007X Physical Therapist, Sports (Licence: CA 296504) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: CA 296504) | |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2021-08-03 |