| NPI | 1639685043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 63740) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL0025330) |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2024-10-28 |