| NPI | 1366102857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 65138) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: VT 040.0134357) |
| Enumeration Date | 2021-12-23 |
| Last Update Date | 2024-01-04 |