| NPI | 1821753203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1346221) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 045583) |
| Enumeration Date | 2021-11-01 |
| Last Update Date | 2026-07-01 |