| NPI | 1700218708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 61585) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305208139) |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2018-04-06 |