| NPI | 1437378288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 62252) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: OR 62252) |
| 261QP2000X Clinic/Center Physical Therapy (Licence: OR 62252) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-10-27 |