| NPI | 1629714282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1360268) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2168536) |
| Enumeration Date | 2022-05-06 |
| Last Update Date | 2022-07-08 |