| NPI | 1629453519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: TX 1051324) |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2020-05-22 |