| NPI | 1134637176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60797104) |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: WA PT60797104) |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2023-08-15 |