| NPI | 1679315626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR CP054411T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA02349000) |
| Enumeration Date | 2024-06-11 |
| Last Update Date | 2026-03-30 |