| NPI | 1710443577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT61033597) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305212610) |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2021-12-30 |