| NPI | 1093521460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT034316) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT61583070) |
| Enumeration Date | 2024-12-10 |
| Last Update Date | 2025-08-25 |