| NPI | 1801208111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1317654) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 116481) |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2020-01-29 |