| NPI | 1558692723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1291900) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 8814) |
| 225100000X Physical Therapist (Licence: VA 2305205551) | |
| Enumeration Date | 2010-01-27 |
| Last Update Date | 2022-07-21 |