| NPI | 1598084675 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60019740) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: WA PT60019740) |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2010-05-27 |