| NPI | 1538256508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 06410) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 31764) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2021-06-14 |