| NPI | 1710556279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT61616794) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225100000X Physical Therapist (Licence: AK 196612) | |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2025-01-03 |