| NPI | 1528618766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 63483) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1317630) |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2021-04-27 |