| NPI | 1548692296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: OR 60312) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 60312) |
| Enumeration Date | 2013-08-05 |
| Last Update Date | 2022-09-23 |