| NPI | 1912955675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: TX 1162753) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 0248161) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2020-09-08 |