| NPI | 1508744905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 12140R) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 13920) |
| Enumeration Date | 2025-08-25 |
| Last Update Date | 2025-09-22 |