| NPI | 1750778205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 60825457) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 20542) |
| 225100000X Physical Therapist (Licence: OR 62675) | |
| 225100000X Physical Therapist (Licence: CA 293061) | |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2020-03-18 |