| NPI | 1568102259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX W0859) |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2026-08-19 |