| NPI | 1437355153 |
|---|---|
| Former Name | LAURA GERTRUDE SAMPLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00003870) |
| Additional Taxonomies | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: WA PT0003870) |
| 2251G0304X Physical Therapist, Geriatrics (Licence: WA PT0003870) | |
| 2251H1200X Physical Therapist, Hand (Licence: WA PT0003870) | |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2009-01-27 |