| NPI | 1780694497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WA PT00003555) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 004154) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2009-09-03 |