| NPI | 1679687628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 3360) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00007163) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2022-03-08 |