| NPI | 1124825484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ CP052517T) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX CP042470T) |
| 208100000X Physical Medicine & Rehabilitation (Licence: LA 11980) | |
| Enumeration Date | 2025-02-25 |
| Last Update Date | 2026-01-30 |