| NPI | 1568749828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 6892) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 004806) |
| 225100000X Physical Therapist | |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2023-01-17 |