| NPI | 1700961851 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 63611) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AK 1607) | 
| Enumeration Date | 2006-10-26 | 
| Last Update Date | 2023-05-22 |