| NPI | 1770063596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501018863) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60895793) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2026-02-25 |