| NPI | 1629813696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0020202) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 13535) |
| 225100000X Physical Therapist (Licence: WA PT61619188) | |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2025-09-03 |