| NPI | 1134105828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT 00003896) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 8707) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2014-12-03 |