| NPI | 1558616656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 60757665) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 08033) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2019-10-28 |