| NPI | 1790480986 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P19748)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX CP032777T)  | 
| 225100000X Physical Therapist (Licence: FL PT40049)  | |
| Enumeration Date | 2023-04-05 | 
| Last Update Date | 2025-09-17 |