| NPI | 1194577163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT61686129) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 050669-01) |
| Enumeration Date | 2024-04-03 |
| Last Update Date | 2025-12-12 |