| NPI | 1598543316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 20220229429) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX CP051353T) |
| Enumeration Date | 2023-09-21 |
| Last Update Date | 2025-12-16 |