| NPI | 1295272219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60933126) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1290469) |
| 225200000X Physical Therapy Assistant (Licence: TX 2126982) | |
| Enumeration Date | 2017-01-28 |
| Last Update Date | 2021-05-17 |