| NPI | 1922638261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1286430) |
| Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: TX 1286430) | |
| Enumeration Date | 2020-01-24 |
| Last Update Date | 2021-10-14 |