| NPI | 1578512380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 4130) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 5873-24) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2024-04-11 |