| NPI | 1588206791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1362594) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT297431) |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2024-05-01 |