| NPI | 1780439513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 14236904-2401) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1389788) |
| Enumeration Date | 2024-04-23 |
| Last Update Date | 2026-01-02 |