| NPI | 1669665626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL0014633) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00010556) |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2017-05-01 |