| NPI | 1588648430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 3571) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 10244) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2007-07-08 |