| NPI | 1649928672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT61268105) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 12733171-2401) |
| Enumeration Date | 2022-03-18 |
| Last Update Date | 2025-10-23 |