| NPI | 1538702774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60975819) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT6206) |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2022-10-14 |