| NPI | 1235611864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA CP011264T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0014935) |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2022-09-22 |