| NPI | 1285748798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00008225) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT1678) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2020-05-15 |