| NPI | 1760079305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: LA 10456R) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: TX 1245616) |
| Enumeration Date | 2020-12-29 |
| Last Update Date | 2020-12-29 |