| NPI | 1598223158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1265496) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0002711) |
| Enumeration Date | 2019-03-03 |
| Last Update Date | 2019-03-03 |