| NPI | 1639358435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60116771) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 4739) |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2009-11-18 |