| NPI | 1396229324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 63170) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 040632) |
| Enumeration Date | 2018-09-14 |
| Last Update Date | 2021-10-28 |