| NPI | 1518315571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60857439) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT PTP-PT-TMP-11039) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2019-04-02 |