| NPI | 1710455357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305214287) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60880421) |
| 225100000X Physical Therapist (Licence: MA PTL25315) | |
| Enumeration Date | 2018-11-12 |
| Last Update Date | 2026-07-07 |