| NPI | 1043791783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2018036204) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1310193) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2018-10-03 |