| NPI | 1376290700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1190629) |
| Additional Taxonomies | 2251N0400X Physical Therapist, Neurology (Licence: TX 1190629) |
| Enumeration Date | 2022-03-06 |
| Last Update Date | 2022-03-06 |