| NPI | 1609693761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1407067) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 30163) |
| Enumeration Date | 2024-09-20 |
| Last Update Date | 2025-08-19 |