| NPI | 1477131175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AK 170412) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1344115) |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2021-04-01 |