| NPI | 1114552635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT61079762) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 24801) |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2023-01-15 |