| NPI | 1609468008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1289518) |
| Enumeration Date | 2021-02-07 |
| Last Update Date | 2024-02-19 |