| NPI | 1962144634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 0736434) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1352684) |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2022-08-24 |