| NPI | 1871338236 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 30191) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT61564061) | 
| Enumeration Date | 2024-06-27 | 
| Last Update Date | 2025-09-12 |