| NPI | 1407055247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00007135) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-1502) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2007-07-12 |