| NPI | 1609585256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1116291) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: TX 1116291) |
| Enumeration Date | 2022-11-22 |
| Last Update Date | 2022-11-22 |