| NPI | 1689279671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 63894) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 61099152) |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2020-11-30 |