| NPI | 1104190552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR OR 61457) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 60259458) |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2016-04-25 |