| NPI | 1295162659 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60794381) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT023168) | 
| 225100000X Physical Therapist (Licence: NY 036897) | |
| Enumeration Date | 2013-10-01 | 
| Last Update Date | 2022-09-19 |