| NPI | 1578005864 |
|---|---|
| Former Name | HEIDI VANDER WOUDE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 60967) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 39702) |
| Enumeration Date | 2016-11-17 |
| Last Update Date | 2020-11-11 |