| NPI | 1699288134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT026605) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX CP034864T) |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2024-10-02 |