| NPI | 1376104141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM PT-2023-2117) |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2023-12-14 |