| NPI | 1679971048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1253107) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 038326-1) |
| Enumeration Date | 2014-12-16 |
| Last Update Date | 2021-04-16 |