| NPI | 1902398902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1306268) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225100000X Physical Therapist (Licence: KS 11-05879) | |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2021-06-09 |