| NPI | 1649086083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA CP038666T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1402486) |
| Enumeration Date | 2024-12-10 |
| Last Update Date | 2025-04-07 |