| NPI | 1942679832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 25546) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1247060) |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2024-02-05 |