| NPI | 1184921363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60600079) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 19426) |
| Enumeration Date | 2011-02-23 |
| Last Update Date | 2015-12-08 |