| NPI | 1639492192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1333576) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 60129128) |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2021-07-14 |