| NPI | 1194453506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1406401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 11220) |
| Enumeration Date | 2022-08-12 |
| Last Update Date | 2026-04-16 |