| NPI | 1871809095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 63055) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1204362) |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2020-11-11 |