| NPI | 1538675152 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1367256) | 
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2131084) | 
| Enumeration Date | 2017-12-19 | 
| Last Update Date | 2024-03-11 |