| NPI | 1750764098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1313675) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY 1583) |
| 225100000X Physical Therapist (Licence: CO 13426) | |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2021-11-04 |