| NPI | 1235561168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1283288) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 036191) |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2021-02-09 |