| NPI | 1114353695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60298971) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WA PT60298971) |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2021-04-22 |