| NPI | 1760883177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305208674) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT 60574854) |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2019-12-31 |