| NPI | 1790422640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR CP011697T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0016802) |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2022-06-08 |