| NPI | 1841612306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 62375) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 24797) |
| Enumeration Date | 2014-01-16 |
| Last Update Date | 2018-03-17 |