| NPI | 1770023699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1285778) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 9175729-2401) |
| Enumeration Date | 2017-02-24 |
| Last Update Date | 2023-09-22 |