| NPI | 1902157845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1214640) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 23988) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2022-07-25 |