| NPI | 1578126744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 64703) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2019030140) |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2022-10-21 |