| NPI | 1609995778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OK PT 1625) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT 450) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2007-07-08 |