| NPI | 1750415774 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00009864) | 
| Additional Taxonomies | 174400000X Specialist (Licence: WA PT00009864) | 
| Enumeration Date | 2007-03-14 | 
| Last Update Date | 2024-05-08 |