| NPI | 1912170531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1217478) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA 004418) |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2020-02-26 |