| NPI | 1104063866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1249827) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CA 20572) |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2025-03-20 |