| NPI | 1831815125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1368801) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0018760) |
| Enumeration Date | 2022-10-18 |
| Last Update Date | 2025-09-03 |