| NPI | 1225011182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00008951) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 18562) |
| 225100000X Physical Therapist (Licence: MI 5501004944) | |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2014-08-04 |