| NPI | 1063244168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1403536) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305216642) |
| Enumeration Date | 2024-08-16 |
| Last Update Date | 2025-01-28 |