| NPI | 1588803456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: OR 5743) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2009-02-16 |
| Last Update Date | 2024-10-23 |