| NPI | 1629776596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1352939) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO CP027822T) |
| Enumeration Date | 2023-02-21 |
| Last Update Date | 2024-02-02 |