| NPI | 1225439532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60502552) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501016929) |
| Enumeration Date | 2014-09-07 |
| Last Update Date | 2020-06-08 |