| NPI | 1710608054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: TX 1365300) |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 049449) | |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2024-07-02 |