| NPI | 1023397577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251N0400X Physical Therapist, Neurology (Licence: OR 62593) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 23764) |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2020-05-14 |