| NPI | 1265051585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: TX 1124428) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1124428) |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2020-05-07 |