| NPI | 1508233750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT 60599455) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: MO 2015027179) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2015-12-02 |