| NPI | 1245858604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 27693) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1362349) |
| 225100000X Physical Therapist (Licence: MO 2020012856) | |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2024-08-06 |