| NPI | 1083998512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: OR 6541) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 6541) |
| 2251S0007X Physical Therapist, Sports (Licence: OR 6541) | |
| Enumeration Date | 2011-10-03 |
| Last Update Date | 2011-10-03 |