| NPI | 1356955751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT61528942) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501019681) |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2025-08-05 |