| NPI | 1700274123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-3650) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60471103) |
| Enumeration Date | 2015-01-07 |
| Last Update Date | 2022-05-09 |