| NPI | 1629053178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 01049) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00003264) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2015-06-05 |