| NPI | 1083723290 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 1278) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 4000) | 
| Enumeration Date | 2006-08-30 | 
| Last Update Date | 2022-03-07 |