| NPI | 1154384915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00007527) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-1745) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2007-07-08 |