| NPI | 1215107164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60150805) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MA00025232) |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2013-05-21 |