| NPI | 1497646475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 65762) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 17228-24) |
| Enumeration Date | 2025-07-09 |
| Last Update Date | 2025-11-03 |