| NPI | 1528752193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ CPT024963T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 120389) |
| 225100000X Physical Therapist (Licence: OR CP029372T) | |
| Enumeration Date | 2023-06-06 |
| Last Update Date | 2024-10-08 |