| NPI | 1649565847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 06511) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 9216) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2022-07-21 |