| NPI | 1467078618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1318870) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0016957) |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2020-06-23 |