| NPI | 1881960508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 008265) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1215363) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2021-08-06 |