| NPI | 1770029456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT 00007204) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR OR 3331) |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2017-01-18 |