| NPI | 1487268249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1329460) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM PT5755) |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2021-02-09 |