| NPI | 1710125794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 06177) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 030170) |
| Enumeration Date | 2009-01-28 |
| Last Update Date | 2021-01-20 |