| NPI | 1710469572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL0015780) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1305766) |
| 225100000X Physical Therapist (Licence: OH PT017762) | |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2025-07-02 |