| NPI | 1235466772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 61407) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT021058) |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2016-09-15 |