| NPI | 1801210323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60447914) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 60473) |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2014-07-30 |