| NPI | 1760120430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1347247) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2024007797) |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2025-09-16 |