| NPI | 1063456804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1270021) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 024831) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2021-06-04 |