| NPI | 1275079774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 00002682) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 00646) |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2017-01-12 |