| NPI | 1790098523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 12544-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60162631) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2017-02-28 |