| NPI | 1942727185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1368061) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 2255A2300x) |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2022-09-26 |