| NPI | 1720323405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 60317318) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12159-24) |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2023-11-06 |