| NPI | 1407364425 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60932673) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT-30539) | 
| 225100000X Physical Therapist (Licence: FL PT33186) | |
| Enumeration Date | 2018-01-11 | 
| Last Update Date | 2021-06-10 |