| NPI | 1558737296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60708769) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-4213) |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2016-12-14 |