| NPI | 1689151839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 64224) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID 6971) |
| 225100000X Physical Therapist (Licence: NC 18003) | |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2021-12-15 |