| NPI | 1962800763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1269920) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2014007710) |
| 225100000X Physical Therapist (Licence: CO 0012334) | |
| Enumeration Date | 2014-12-10 |
| Last Update Date | 2019-06-13 |