| NPI | 1578307898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 65451) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 14273227-2401) |
| Enumeration Date | 2024-06-21 |
| Last Update Date | 2026-02-24 |