| NPI | 1811602592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 11672796-2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.16795) |
| Enumeration Date | 2023-01-17 |
| Last Update Date | 2023-05-11 |