| NPI | 1669204319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 3134436) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2139411) |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2025-11-02 |