| NPI | 1417402934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 61799) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 21959) |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2016-08-25 |