| NPI | 1942653076 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 11959466-2401) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 291557) | 
| Enumeration Date | 2016-07-13 | 
| Last Update Date | 2022-04-04 |