| NPI | 1710596200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1335911) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 3125674) |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2024-04-18 |