| NPI | 1861800930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60588021) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 10134) |
| Enumeration Date | 2014-08-01 |
| Last Update Date | 2016-01-04 |