| NPI | 1578947495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1269492) |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: TX 1269492) |
| 225100000X Physical Therapist (Licence: DE J1-0003351) | |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2024-02-02 |