| NPI | 1497256937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305213259) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1302073) |
| Enumeration Date | 2018-02-21 |
| Last Update Date | 2020-09-01 |