| NPI | 1942780879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 65865) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1307341) |
| Enumeration Date | 2018-08-20 |
| Last Update Date | 2026-01-22 |