| NPI | 1821483918 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 63923) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NV 6396) | 
| 225100000X Physical Therapist (Licence: CA PT 28073) | |
| Enumeration Date | 2015-04-06 | 
| Last Update Date | 2025-03-18 |