| NPI | 1063879765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 61513) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2014026993) |
| Enumeration Date | 2016-01-26 |
| Last Update Date | 2016-01-26 |