| NPI | 1770207896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1363989) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM PT22002) |
| 225100000X Physical Therapist (Licence: AZ CP015279T) | |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2022-11-08 |