| NPI | 1508641911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 65500) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1382760) |
| Enumeration Date | 2023-08-25 |
| Last Update Date | 2024-10-07 |