| NPI | 1831295591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00005619) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 2307) |
| 225100000X Physical Therapist (Licence: NC 4816) | |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2021-04-26 |