| NPI | 1215170683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60221306) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT23995) |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2013-01-02 |