| NPI | 1972353258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 31856) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1385754) |
| Enumeration Date | 2024-03-27 |
| Last Update Date | 2025-05-30 |