| NPI | 1770321069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 12830) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM PT-2024-0327) |
| 225100000X Physical Therapist (Licence: WA PT61575795) | |
| Enumeration Date | 2024-07-19 |
| Last Update Date | 2025-05-15 |