| NPI | 1629265954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 6465) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00010245) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2012-05-30 |