| NPI | 1235023821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 17183-24) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: WI 1718324) |
| Enumeration Date | 2025-06-06 |
| Last Update Date | 2025-06-20 |