| NPI | 1881873289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 2503) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR PT00005635) |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2022-04-12 |