| NPI | 1790088565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2005029648) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 2630) |
| 225100000X Physical Therapist (Licence: MN 8661) | |
| 225100000X Physical Therapist (Licence: OR 5434) | |
| 225100000X Physical Therapist (Licence: FL 28326) | |
| Enumeration Date | 2010-12-16 |
| Last Update Date | 2025-05-29 |