| NPI | 1801200308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA CP011263T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 10898) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2022-04-25 |