| NPI | 1639880107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: TX 1363930) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2022-12-06 |
| Last Update Date | 2026-04-06 |