| NPI | 1619700564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0020089) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA PTL27807) |
| 225100000X Physical Therapist (Licence: WY PT-2551) | |
| Enumeration Date | 2024-08-24 |
| Last Update Date | 2025-11-05 |