| NPI | 1972294932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX CP030799T) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: LA 11499) |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: AZ CP024641T) | |
| Enumeration Date | 2023-05-18 |
| Last Update Date | 2024-04-27 |