| NPI | 1831503150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 60427) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 60439191) |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2015-05-30 |