| NPI | 1275942062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 12373136-2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 0012836) |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2023-08-15 |