| NPI | 1821459561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NM 4456) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1288655) |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2023-04-17 |