| NPI | 1710205851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 60088) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 23209) |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2016-07-06 |