| NPI | 1073095303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 62956) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 040.0134018) |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2018-09-04 |