| NPI | 1801377627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1279951) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 300396) |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2021-07-08 |