| NPI | 1457878290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1311640) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AR PT4340) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2022-07-21 |