| NPI | 1215521638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 12148961-2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0020733) |
| 225100000X Physical Therapist (Licence: SC 12590) | |
| Enumeration Date | 2021-02-25 |
| Last Update Date | 2025-08-27 |