| NPI | 1629725437 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1357300) | 
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 1357300) | 
| Enumeration Date | 2022-03-02 | 
| Last Update Date | 2022-09-19 |