| NPI | 1144655168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT 60339045) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-3333) |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2013-12-06 |