| NPI | 1134412141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60218853) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 1495) |
| 2251S0007X Physical Therapist, Sports (Licence: WA PT 60218853) | |
| 2251S0007X Physical Therapist, Sports (Licence: OR 1495) | |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2019-04-16 |