| NPI | 1205213451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT6975244) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 009674) |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2019-07-19 |