| NPI | 1265642649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1311392) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OK 3506) |
| 225100000X Physical Therapist (Licence: NC 2589) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2021-08-03 |