| NPI | 1972001261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14954) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 14175) |
| 225100000X Physical Therapist (Licence: OR 62615) | |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2025-11-30 |