| NPI | 1679403927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT034281) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX CP058312T) |
| Enumeration Date | 2026-05-20 |
| Last Update Date | 2026-06-11 |