| NPI | 1730070764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI PT017722) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 1257926) |
| Enumeration Date | 2025-07-09 |
| Last Update Date | 2026-08-17 |