| NPI | 1205022589 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 5221) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00010689) | 
| Enumeration Date | 2007-09-19 | 
| Last Update Date | 2007-12-06 |