| NPI | 1477121887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: 2154572) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1407196) |
| Enumeration Date | 2021-06-12 |
| Last Update Date | 2025-08-26 |