| NPI | 1891058129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60622029) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN Permit 2886) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2023-08-01 |