| NPI | 1285009126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1319177) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 23548) |
| 225100000X Physical Therapist (Licence: CA 43465) | |
| Enumeration Date | 2015-12-03 |
| Last Update Date | 2022-04-08 |