| NPI | 1710539168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1312289) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX 1312289) |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: TX 454874) | |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2024-11-14 |