| NPI | 1952787335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 62966) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT30621) |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2018-09-18 |