| NPI | 1609500578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NC A8566) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX 2169579) |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2025-07-22 |