| NPI | 1871620963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00010765) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 17151) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2011-10-18 |