| NPI | 1164261624 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-034386)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT61662330)  | 
| 225100000X Physical Therapist | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2024-05-23 | 
| Last Update Date | 2025-10-09 |