| NPI | 1710121827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60247688) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT 497) |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2012-04-17 |