| NPI | 1659825784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 10968R) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1274956) |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2021-07-26 |