| NPI | 1578786679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-2966) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00010803) |
| 225100000X Physical Therapist (Licence: IA 04023) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-06-04 |