| NPI | 1982950820 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1317418) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT37944) | 
| Enumeration Date | 2012-07-30 | 
| Last Update Date | 2025-04-07 |