| NPI | 1083080311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1303260) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 62038751) |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2021-07-27 |