| NPI | 1114560729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 27796) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1312917) |
| Enumeration Date | 2019-10-26 |
| Last Update Date | 2019-11-18 |