| NPI | 1164900890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 64693) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA 294962) |
| Enumeration Date | 2018-08-03 |
| Last Update Date | 2023-01-11 |