| NPI | 1891109344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60453848) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: WA PT 60453848) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: WA PT60453848) | |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2023-04-18 |