| NPI | 1073096723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA CP004609T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 62983) |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2021-06-02 |