| NPI | 1184961591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60491170) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL PTH6664) |
| 225100000X Physical Therapist (Licence: OH PT.013277) | |
| 225100000X Physical Therapist (Licence: WA 60491170) | |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2021-01-29 |