| NPI | 1861822595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60218323) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT2904) |
| Enumeration Date | 2013-11-15 |
| Last Update Date | 2023-04-26 |