| NPI | 1215865068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1267649) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA PTL28274) |
| 225100000X Physical Therapist (Licence: NY 038397) | |
| Enumeration Date | 2026-05-12 |
| Last Update Date | 2026-05-12 |