| NPI | 1043519044 |
|---|---|
| Former Name | LESLIE WASHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-006156) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 6156) |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2019-11-13 |