| NPI | 1154492981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00007791) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 3856) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2011-03-14 |