| NPI | 1699752782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00009312) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 7261) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2007-07-08 |