| NPI | 1316770399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT70040986) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT017302) |
| Enumeration Date | 2024-08-23 |
| Last Update Date | 2025-08-29 |