| NPI | 1770353641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1391726) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2180013) |
| Enumeration Date | 2024-01-03 |
| Last Update Date | 2025-08-13 |