| NPI | 1831401223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1204940) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM 3806) |
| 225100000X Physical Therapist (Licence: MI 5501014853) | |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2022-03-03 |