| NPI | 1609532613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1288520) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OK 2887) |
| Enumeration Date | 2021-11-14 |
| Last Update Date | 2022-11-18 |