| NPI | 1972820611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: TX 142657) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1176643) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2023-05-04 |