| NPI | 1639710320 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 60998471) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC CP048826T) | 
| Enumeration Date | 2019-10-03 | 
| Last Update Date | 2025-09-16 |