| NPI | 1790531085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 14003759-2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0018389) |
| Enumeration Date | 2024-04-26 |
| Last Update Date | 2025-01-14 |