| NPI | 1629810957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: TX 1396578) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: TX 3132905) |
| Enumeration Date | 2024-06-07 |
| Last Update Date | 2024-08-26 |