| NPI | 1215509385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1347064) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05012162A) |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2025-09-28 |