| NPI | 1720409006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: OR 04799) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 4799) |
| Enumeration Date | 2014-01-03 |
| Last Update Date | 2020-04-09 |