| NPI | 1699703447 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 8983)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 9896)  | 
| 225100000X Physical Therapist (Licence: CA 38722)  | |
| Enumeration Date | 2006-06-29 | 
| Last Update Date | 2017-09-08 |