| NPI | 1598132052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1330262) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-04339) |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2021-05-14 |