| NPI | 1801670096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: NC CP033653T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1382280) |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2025-07-28 |