| NPI | 1841704756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 60120433) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID 1497) |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2017-11-30 |