| NPI | 1376910067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60569869) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 34641) |
| 225100000X Physical Therapist (Licence: CO PTL.00013494) | |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2015-10-07 |