| NPI | 1902389182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1338849) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 090884) |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2021-03-22 |