| NPI | 1366141749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1403584) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OK 5955) |
| Enumeration Date | 2023-02-24 |
| Last Update Date | 2025-03-10 |