| NPI | 1548850712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT61122895) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WA PT61122895) |
| Enumeration Date | 2021-01-21 |
| Last Update Date | 2021-11-19 |