| NPI | 1013080555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-010233) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT9635) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2026-01-07 |