| NPI | 1598366874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1333302) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.025275) |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2020-12-28 |