| NPI | 1205504974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 65973) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 306481) |
| 225100000X Physical Therapist (Licence: MA 25574) | |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2026-07-29 |