| NPI | 1265473052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00008444) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT 2000) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2013-08-07 |