| NPI | 1659969152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 63921) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OR 63921) |
| Enumeration Date | 2021-01-10 |
| Last Update Date | 2024-11-18 |