| NPI | 1063658706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NM PT3987) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM 3987) |
| 225100000X Physical Therapist (Licence: TX 1087419) | |
| Enumeration Date | 2008-12-31 |
| Last Update Date | 2021-04-30 |