| NPI | 1629883939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305216842) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX CP048560T) |
| Enumeration Date | 2025-02-12 |
| Last Update Date | 2025-09-09 |