| NPI | 1053650564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1368670) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT28385) |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2025-05-02 |