| NPI | 1982053591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2021013136) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1273480) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2022-01-19 |