| NPI | 1164792081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: TX 1104305) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 8793) |
| Enumeration Date | 2012-01-09 |
| Last Update Date | 2023-08-07 |