| NPI | 1912419961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1292957) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: TX 1292957) |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2024-02-09 |