| NPI | 1477041259 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1312892) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 22842) | 
| Enumeration Date | 2018-04-26 | 
| Last Update Date | 2024-03-12 |