| NPI | 1770360414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: OR 64616) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2023-09-14 |
| Last Update Date | 2024-07-26 |