| NPI | 1568727055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT 60386911) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 06927) |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2014-12-04 |