| NPI | 1255134631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT61659036) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ AZCP043703T) |
| Enumeration Date | 2025-03-31 |
| Last Update Date | 2025-04-17 |