| NPI | 1104256353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 3026) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00010068) |
| Enumeration Date | 2013-11-24 |
| Last Update Date | 2013-11-24 |