| NPI | 1700302114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA CP008580T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60757895) |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2022-02-22 |