| NPI | 1770352445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX CP033544T) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2023-12-22 |
| Last Update Date | 2024-10-08 |