| NPI | 1831663400 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist | 
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: TX 1281082)  | 
| Enumeration Date | 2019-01-17 | 
| Last Update Date | 2025-06-04 |