| NPI | 1699454710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT61685064) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM PT-2024-0206) |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2025-05-07 |