| NPI | 1578161790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 61201706) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 299127) |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2022-09-08 |