| NPI | 1841074960 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 12896616-2401) | 
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: UT 12896616-2401) | 
| Enumeration Date | 2023-08-21 | 
| Last Update Date | 2024-03-04 |