| NPI | 1962121848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1400572) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT39123) |
| Enumeration Date | 2022-08-24 |
| Last Update Date | 2024-09-17 |