| NPI | 1164901252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TX 2065883) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 2065883) |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2021-10-05 |