| NPI | 1992313324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OK 6401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1331888) |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2024-08-05 |