| NPI | 1780101352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA CP003419T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305210948) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2020-09-24 |