| NPI | 1710315452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT 60506457) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12539-24) |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2015-07-10 |