| NPI | 1972121713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: WA PT.PT.70001700) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P19580) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: ID PT-8334) | |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2025-07-07 |