| NPI | 1851373997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00003874) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 1365) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2013-10-09 |