| NPI | 1114158235 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT009703) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60974827) | 
| Enumeration Date | 2009-08-06 | 
| Last Update Date | 2020-11-05 |