| NPI | 1700516663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT61527740) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2022025186) |
| 225100000X Physical Therapist (Licence: ID 8094) | |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2024-03-05 |