| NPI | 1104548197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 61352735) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1365131) |
| Enumeration Date | 2022-09-15 |
| Last Update Date | 2023-03-28 |