| NPI | 1083348122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1407780) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: FL PT37716) |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2026-01-14 |