| NPI | 1528489648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60595912) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305208457) |
| Enumeration Date | 2013-12-16 |
| Last Update Date | 2016-09-21 |