| NPI | 1861903262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1402134) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2130673) |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2024-12-17 |