| NPI | 1396953162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60399445) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-03519) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2022-03-10 |