| NPI | 1861018855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1331424) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ CP011501T) |
| 225100000X Physical Therapist (Licence: VA CP015171T) | |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2022-09-14 |