| NPI | 1760192090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1391211) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT39697) |
| Enumeration Date | 2022-11-28 |
| Last Update Date | 2024-07-31 |