| NPI | 1588268700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 63940) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2018028471) |
| Enumeration Date | 2020-11-29 |
| Last Update Date | 2021-03-08 |