| NPI | 1245431279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 5411) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID 1622) |
| 225100000X Physical Therapist (Licence: OR 2219) | |
| 225100000X Physical Therapist (Licence: HI 1537) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2007-07-08 |