| NPI | 1801695085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1405539) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ CP049503T) |
| Enumeration Date | 2025-03-11 |
| Last Update Date | 2025-11-04 |