| NPI | 1710363833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 63609) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 006655) |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2025-07-29 |