| NPI | 1215054465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 2826812401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY 924) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2021-12-20 |