| NPI | 1356080972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1361579) |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy (Licence: TX 1361579) |
| Enumeration Date | 2022-06-01 |
| Last Update Date | 2023-10-24 |