| NPI | 1992093991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 7070) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1208646) |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2021-11-17 |