| NPI | 1558071423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1286208) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI CP037176T) |
| Enumeration Date | 2022-12-01 |
| Last Update Date | 2024-12-09 |