| NPI | 1083191803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 63902) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: CA 291982) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: OR 63902) | |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2020-12-16 |