| NPI | 1104657709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1407566) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 052491) |
| Enumeration Date | 2024-08-13 |
| Last Update Date | 2025-11-14 |