| NPI | 1851907091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 64309) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT36045) |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2022-12-20 |