| NPI | 1649046657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 11684R) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1383672) |
| Enumeration Date | 2023-11-30 |
| Last Update Date | 2026-07-22 |