| NPI | 1740924620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: OR 64412) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: OR 64412) |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2024-10-22 |